Implantable Electrode Arrangement

Abstract

An implantable electrode arrangement ( 1 ) for stimulating excitable tissue, in particular the neosphincter to control urinary incontinence. The electrode is in the form of a extending peg with a pair of electrode elements ( 2, 3 ) extending from a base ( 4 ). The elements are arranged to fit over the tissue to be stimulated and have electrodes ( 5, 6 ) on the inner surfaces of the peg portions. The tissue located between the peg portions receives stimulation. Also disclosed are methods of treating urinary incontinence by electrically stimulating a band of smooth muscle and electrode having an insulating member and electrodes on the inner surface such that an electric field applied to tissue is confined.

1 . An implantable electrode arrangement, for stimulating contractile tissue, the electrode arrangement comprising first and second electrode elements being arranged, in use, to extend with respect to each other so as to form a gap between them arranged for receiving contractile tissue, the first and second electrode elements including first and second electrodes respectively, the first and second electrodes being positionable, in use, in proximity to each other and being arranged, when an electrical signal is applied to them, to apply an electric field between them to stimulate the contractile tissue between them. 
   
   
       2 . An implantable electrode arrangement in accordance with  claim 1 , the first and second electrodes being positionable, in use, opposite to each other. 
   
   
       3 . An electrode arrangement in accordance with  claim 1 , wherein each electrode element has a length dimension and a width dimension, and the length dimension is substantially longer than the width dimension, so that the electrode elements are of elongate form. 
   
   
       4 - 5 . (canceled) 
   
   
       6 . An electrode arrangement in accordance with  claim 3 , wherein a depth dimension of the electrode elements is smaller than the width dimension. 
   
   
       7 . An electrode arrangement in accordance with  claim 6 , the electrode elements being substantially flat in profile. 
   
   
       8 . An electrode arrangement in accordance with  claim 1 , wherein the first and second electrodes are provided on inner surfaces of the first and second electrode elements, in use being arranged to contract opposite parts of the tissue so that a portion of the tissue lies between them. 
   
   
       9 - 28 . (canceled) 
   
   
       29 . An electrode arrangement in accordance with  claim 1 , the first and second electrode elements being mounted at proximal ends thereto to a mounting, from which they extend with respect to each other so as to form a gap between them for receiving the tissue. 
   
   
       30 . An electrode arrangement in accordance with  claim 29 , the electrode elements being in the form of fingers extending from the mounting, the mounting forming a base connecting the fingers at their proximal ends. 
   
   
       31 . An electrode arrangement in accordance with  claim 30 , wherein the gap is open on all sides apart from where the electrode elements are joined at the base, so that the arrangement may be placed over the tissue from one end, in an analogous manner to a peg. 
   
   
       32 . An electrode arrangement in accordance with  claim 1 , wherein the electrode elements are flexible, whereby to enable them to adapt to the shape of the received tissue and/or external tissue that they may be seated against in use. 
   
   
       33 . An electrode arrangement in accordance with  claim 1 , the first and second electrodes being arranged to create a confined electric field between them when an electrical signal is applied to them, in order to stimulate the tissue. 
   
   
       34 - 38 . (canceled) 
   
   
       39 . An electrode arrangement for controlling urinary incontinence, including an electrode arrangement in accordance with  claim 1 , arranged to be implantable in a patient to stimulate contractile tissue to control urinary incontinence. 
   
   
       40 . An electrode arrangement in accordance with  claim 39 , being arranged such that the first and second electrode elements are positionable either side of a band of tissue forming a portion of neosphincter wrapped around the urethra, the neosphincter being arranged to contract on stimulation by the electrodes, in order to maintain continence. 
   
   
       41 . A method of stimulating contractile tissue, comprising the steps of operating an electrode arrangement in accordance with  claim 1 , wherein contractile tissue lies between the electrode elements, and applying an electrical stimulus to the electrodes to create a confined electric field between the electrodes to stimulate the tissue. 
   
   
       42 . A method in accordance with  claim 41 , wherein the contractile tissue is formed into a neosphincter about the patient's urethra, for controlling urinary incontinence. 
   
   
       43 - 46 . (canceled) 
   
   
       47 . A method of treating urinary incontinence, comprising the steps of surgically implanting an electrode arrangement in accordance with  claim 1 , so that the electrode elements extend about a portion of a contractile tissue sphincter arranged about the urethra, and providing electrical signals to the electrodes causing the sphincter to contract and prevent urine from passing through the urethra. 
   
   
       48 . A method in accordance with  claim 47 , wherein the contractible tissue is smooth muscle. 
   
   
       49 . A method in accordance with  claim 48 , wherein the step of implanting the electrode arrangement includes the step of implanting the electrode arrangement so that the electrodes run substantially at right angles to the nerves of the smooth muscle tissue. 
   
   
       50 . A method of treating urinary incontinence, comprising the steps of electrically stimulating a smooth muscle sphincter arranged about the urethra, the step of electrically stimulating including electrically stimulating a band of muscle of the smooth muscle sphincter. 
   
   
       51 - 82 . (canceled) 
   
   
       83 . An apparatus for stimulating excitable tissue, the apparatus comprising an implantable electrode arrangement in accordance with  claim 1 , and a stimulator, the stimulator being arranged to provide signals to the first and second electrodes for stimulation of the contractile tissue. 
   
   
       84 . An apparatus in accordance with  claim 83 , further comprising a stimulator controller, the stimulator controller arranged to be operable to control the stimulation signals provided by the stimulator. 
   
   
       85 . An apparatus in accordance with  claim 83 , further comprising a stimulator programmer, the stimulator programmer being arranged to program control parameters of the stimulator. 
   
   
       86 - 129 . (canceled)